Wiki 22551 with Corpectomy code

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celesteturner

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Hi,
I am getting denials from Blue Cross for the new Cervical Arthrodesis code. Blue Cross will not pay 22551 when coded/billed with 63081. The book does not state that a Cervical Corpectomy is included with CPT 22551.
Has or this happening to anyone else? Thanks for any and all input.
 
celesteturner said:
Hi,
I am getting denials from Blue Cross for the new Cervical Arthrodesis code. Blue Cross will not pay 22551 when coded/billed with 63081. The book does not state that a Cervical Corpectomy is included with CPT 22551.
Has or this happening to anyone else? Thanks for any and all input.
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When using the corpectomy codes, the disc above and below the vertebral segment site are included and discectomy for decompression codes are not separately reported. 63075/63076 (which is a component of 22551) are not separately reported unless done at another site. By billing 63081 and 22551, you are essentially trying to report the discectomy twice. This may be a matter of reporting 63081 and 22554 (assuming a fusion was done and same site)
 
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RebeccaWoodward* said:
When using the corpectomy codes, the disc above and below the vertebral segment site are included and discectomy for decompression codes are not separately reported. 63075/63076 (which is a component of 22551) are not separately reported unless done at another site. By billing 63081 and 22551, you are essentially trying to report the discectomy twice. This may be a matter of reporting 63081 and 22554 (assuming a fusion was done and same site)
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Its the same site. They are doing the fusion at C5-C6 and doing a corpectomy at both C5-C6 verterbal segments. So even though, 22551 does not specifically state that a corpectomy is included, I cannot code/bill for 63081?

I know that I can still use 22554 and 63081 with Workers Compensation. But for regular PPo/HMO insurance, i am not sure if still use 22554 and 63081.
 
celesteturner said:
Its the same site. They are doing the fusion at C5-C6 and doing a corpectomy at both C5-C6 verterbal segments. So even though, 22551 does not specifically state that a corpectomy is included, I cannot code/bill for 63081?

I know that I can still use 22554 and 63081 with Workers Compensation. But for regular PPo/HMO insurance, i am not sure if still use 22554 and 63081.
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Per AANS, 22554 and 63081 are billable. I have an article regarding this. Do you want me to fax/email a copy?
 
celesteturner said:
Yes, please. My fax number is 310-322-6660. Do you have anything in regards 22551 as included/bundled with 63081.

Thank you for answering all my questions. I appreciate it!
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I don't have anything in writing. The rational for not reporting 22551/63081 together is that discectomies above and below are included in the corpectomy code. 22551 (22554 + 63075) represents the fusion and the discectomy. Since the discectomy is included, that leaves you with 22554; which is reportable with 63081.
 
The reason they are probaly denying is because medicare bundles corpectomies and osteotomies to 22551...
 
RebeccaWoodward* said:
I don't have anything in writing. The rational for not reporting 22551/63081 together is that discectomies above and below are included in the corpectomy code. 22551 (22554 + 63075) represents the fusion and the discectomy. Since the discectomy is included, that leaves you with 22554; which is reportable with 63081.
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Rebecca,
Would you mind emailing (cvasquez@rbjc.com) or faxing (713-452-4167) a copy to me? A co-worker and I have been trying to make sense of this. Your help is greatly appreciated.
Thanks!
 
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